HIV
guide

Definition

What is HIV?

The human immunodeficiency virus (HIV) weakens the immune system, making it harder to fight off infections.
According to the Centers for Disease Control and Prevention (CDC), there are more than 56,000 new HIV
infections in the United States every year … and about 1.1 million people are infected and living with
the virus. Unfortunately, one in five of people with HIV have not been tested and diagnosed, and are therefore
not receiving proper treatment to manage its damaging effects.

HIV is transmitted through unprotected vaginal, anal or oral sex when the blood, semen or vaginal
secretions of an infected partner enter your body. Although rare, you can also get HIV from blood transfusions,
or by sharing needles or syringes that are contaminated with infected blood. Additionally, infected mothers run
the risk of transmitting HIV to their babies during pregnancy, delivery or while breastfeeding.

What's the connection between HIV and AIDS?

While HIV causes acquired immune deficiency syndrome (AIDS) — a chronic, often life-threatening
condition — not everyone who is HIV-positive has AIDS. It's possible to have HIV for years and not
develop or show any signs or symptoms of the
disease.

While HIV is not curable, it can be treated and managed with highly active antiretroviral therapy (HAART).
These multi-drug regimens slow down the potential of developing AIDS and other infections (including
tuberculosis), certain cancers, weight loss, dementia and other health problems … even death.*

That said, being HIV-positive is not a death sentence. As HIV medications become more and more
effective, people with HIV who are on treatment can expect to live a long time. The earlier HIV is diagnosed,
the more successfully it can be managed to maintain a good quality of life for as long as possible …
early detection is key.

Reference

Risk

HIV risk factors

How do people get infected with HIV?

Anyone can get HIV … usually through sexual activity, especially unprotected vaginal and anal
intercourse, but also through oral sex. The most common risk factors are:

A history of STDs

A history of unprotected sex

A new sexual partner

Multiple sexual partners

Gay, bisexual and other men who have sex with men (MSM)

Uncircumcised men

Healthcare workers exposed to blood

Intravenous (IV) drug use

Due to reporting disparities and a number of other variables, there is a higher prevalence of HIV among
sexually active African-Americans and Hispanics … especially men. Generally-speaking, some
ethnic/minority groups are more likely to use public clinics that report STD cases. As well, awareness of
STDs and how to prevent them, and access to regular healthcare are inconsistent among populations that are
disadvantaged by poverty and other social determinants … these groups may therefore be more likely to
engage in risky sexual activity.

To protect others if you are HIV positive, be sure to use a latex condom every time you have vaginal or
anal sex … and use a condom or dental dam if you have oral sex, too.

What are some ways that HIV cannot be spread?

You cannot get HIV through everyday contact with people who are infected with the virus … or through
contact with their urine, sweat, tears, coughs or sneezes. And you cannot get HIV by "dry" kissing an infected
person … but we recommend that you avoid deep kissing, especially if there are cuts or sores in the
mouth.

As well, you cannot get HIV from mosquitoes, toilet seats, eating utensils, phones, or the like.

Want to learn more?

Symptoms

HIV signs and symptoms

HIV can be asymptomatic (no symptoms) for 10 or more years before the immune system deteriorates, and signs
and symptoms become more apparent … ultimately resulting in AIDS. According to the Centers for Disease
Control and Prevention (CDC), one in five (20%) people with HIV are unaware of their infection, and may be
unknowingly transmitting the virus to others … that's why getting tested is so important.

If you do show symptoms within two to four weeks of initial exposure to HIV infections, they may
include:

In later years, as immune cells are destroyed by the virus, additional symptoms may include:

Various mild Infections

Diarrhea or weight loss

Chronic coughing or difficulty breathing

Skin rashes or lesions

As HIV spreads and the immune system is continually weakened, symptoms may also include:

Fatigue

Joint pain

Mouth sores or gingivitis (gum disease)

Oral thrush (white lesions in the mouth and on the tongue)

Other fungal infections on the skin or nails

Dementia

Certain types of cancer

Last reviewed by Lisa Oldson, MD, January 2011.

Complications

HIV complications

What if HIV is untreated?

Left undiagnosed and untreated, HIV infection generally progresses to AIDS within about 10 years of the
initial exposure to the virus. By that time, the immune system has been significantly damaged, making it very
hard to fight off even mild infections. Signs and symptoms may include:

Without treatment, people infected with HIV are particularly susceptible to a number of infections, cancers
and parasites … from pneumonia, tuberculosis and liver disease to herpes, hepatitis, meningitis
(inflammation of the membranes around the brain and spinal cord), non-Hodgkin lymphoma, and other diseases and
complications. Caught early, however, HIV can be managed with treatment. That's why getting tested is so
important.

HIV and AIDS

According to the Centers for Disease Control and Prevention (CDC), more than 56,000 Americans become
infected with HIV annually, and some 14,000 people with AIDS die every year in the United States. Remember, if
you are tested and treated early, you can focus your energies on living with HIV … rather than
being concerned about dying from the disease.

To minimize your risk of becoming infected or spreading the infection to others, get an HIV test if you think you might have been exposed to the virus
… and continue to use latex condoms. Also, if you use a needle to inject drugs, be sure it's sterile
and don't share it with anyone else.

HIV and pregnancy

Pregnant women with HIV may transmit the virus to their baby during pregnancy, delivery or while
breastfeeding. But if women receive treatment for HIV infection during pregnancy, the risk to their babies is
significantly reduced.

If you're pregnant and concerned about HIV, be sure to consult your regular doctor.

Last reviewed by Lisa Oldson, MD, January 2011.

Testing

HIV testing

How do I get tested for HIV?

We make getting tested for HIV simple by offering the HIV Antibody Test. It is safe, reliable and easy (no
undressing or swabbing required!). Just one fast blood draw and you're on your way.

The HIV Antibody Test is the most common detector for HIV-1 and HIV-2. This test looks for antibodies of the
viruses in the blood and has an accuracy rate of 99% after the testing window has expired.

The testing window for HIV, or the amount of time that it takes for the virus to be detectable, can range
anywhere from 2 to 12 weeks after initial exposure.

"Confirmation" simply means that all positive test results are followed up with another test to confirm the
results … using the same blood sample and with no additional cost to you.

What HIV test results mean

A negative HIV test result means that the virus was not detected in your blood. But because HIV may not yet
be detectable if you get tested too soon after possible exposure to the virus, you'll want to get tested again
three months after exposure to confirm that you're negative. Repeat testing after seroconversion is complete
is critical to ensure the most accurate diagnosis.

A positive HIV test result means that you may be infected with HIV … but that doesn't necessarily
mean you have AIDS, which is the final and most serious stage of HIV infection. Even better, thanks to
antiretroviral therapy that slows down the progression to AIDS, a positive test result is not a death
sentence … HIV infection can be treated and managed to maintain a good quality of life for as long as
possible.

If you test positive, we're here to help. You'll have the opportunity to consult with a doctor on the phone
right away. We'll answer your questions and help you determine the next steps based on your specific
circumstances.

Note: As with hepatitis B and C, if you test positive for HIV, you should not donate blood.

Understanding false-positive or false-negative test results

As with most medical tests, there's a chance that a positive test result indicates an infection when there
isn't one (false-positive); or a test comes back negative, despite the presence of infection (false-negative).
For example, a false-negative test result can happen if an infected person tests too early for a positive
infection to be detected … that means it's possible to get a negative test result but still have HIV or
another STD.

If you're concerned about the reliability of your test results for any reason (e.g., timing, or your sexual
history, or your partner's sexual history), we recommend that you get re-tested three months after your
possible exposure to the virus to confirm your results … and to minimize the risk of being a carrier
and potentially developing more serious
symptoms down the road.

Learn more about "testing
windows" — the recommended amount of time between potential exposure to an STD infection, and when
screening is expected to identify the infection (or reinfection); for example, if you had unprotected sex last
night and became infected with HIV, the virus wouldn't necessarily show up right away … it can take up
to three months to test positive although, again, most people infected with HIV will develop detectable
antibodies within 25 days of exposure.

Last reviewed by Lisa Oldson, MD, January 2011.

Treatment

HIV treatment

Is there a cure or treatment for HIV?

Yes. Once you've been tested and diagnosed with HIV,
multi-drug regimens can control its symptoms and suppress its replication and damage to the immune system.
While HIV is not curable, it can be treated and managed with highly active antiretroviral therapy (HAART) to
maintain a good quality of life for as long as possible … most people start treatment as soon as they
test positive to stave off HIV signs, symptoms and complications.

A combination of drugs can be used to control the virus. The classes of HIV medications are:

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Nucleoside reverse transcriptase inhibitors (NRTIs)

Protease inhibitors

Entry inhibitors (e.g., Maraviroc)

Fusion inhibitors (e.g., Fuzeon)

Integrase inhibitors

Viral loads and CD4 counts

Response to treatment is measured by viral load (the amount of HIV in the blood) and CD4 counts (the number
of white blood cells that fight infection). Viral loads are typically tested every three to four months during
therapy, and CD4 counts are generally checked every three to six months.

Ideally, HIV treatment reduces viral load to the point where it's undetectable … but you can still
pass the virus to others when your viral load is undetectable, so be sure to continue using a latex condom or
dental dam during all sexual activity.

If I know I've been exposed to HIV, what should I do?

If you know you've recently been exposed to HIV, call your doctor or go to the nearest Emergency Room right
away … receiving antiretroviral treatment within 72 hours of exposure may prevent your developing the
disease. Specialists recommend starting that antiretroviral treatment immediately, ideally within the first 24
hours of exposure.

Note: People infected with HIV often experience the flu-like symptoms of what's called Acute
Retroviral Syndrome within two to four weeks of exposure. This is when the virus is most infectious …
if you think you may have been exposed to HIV within the last month or two, it's imperative that you get
tested and treated, and that you use latex condoms during all sexual activity.

What's the connection between HIV and AIDS?

While HIV causes AIDS, not everyone who is HIV-positive has AIDS. Remember, it's possible to have HIV for
years and not develop or show any signs or symptoms of the disease. Treatment can slow down the potential of
developing AIDS and other infections (including tuberculosis), certain cancers, weight loss, dementia and
other health problems.

Pregnancy and treatment

In general, HIV can be treated during pregnancy, greatly reducing the potential risks to your baby.
Consult your regular doctor about the risks involved, and to identify a treatment that's best for you
and your baby.

Last reviewed by Lisa Oldson, MD, January 2011.

Concerned about HIV?

Find out if you should get tested today; peace of mind has never been easier. Questions about our process? See how our STD testing works.

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